| Description |
Some evidence supports the development of holistic interventions that address the overlap between obesity and depression, the both of which have increased burden among women in marginalized communities. Additional understanding about the interrelationships between obesity, health behaviors, and depression could improve the effectiveness of interventions and promote both obesity- and depression-related wellness. Objectives: 1) Evaluate the competency of wellness coaches in utilizing motivational interviewing and its impact on participant factors. 2) Assess how intensity of wellness coaching, fruit/vegetable consumption, and physical activity behaviors are associated with improved depression screen over 12 months. 3) Assess how fruit/vegetable consumption, physical activity behaviors, and depressive symptoms are associated with clinically significant improvements in adiposity over 12 months. Methods: The University of Utah, Utah Department of Health, and African American, African immigrant, Hispanic/Latino, American Indian/Alaskan Native, and Pacific Islander communities partnered to develop and conduct a randomized trial of wellness coaching for women. Health behavior change was the primary target, but a comprehensive paradigm enabled evaluation of relationships between health behaviors and both obesity-related factors and depression. Wellness coaches from each community recruited women (n = 485) who were randomized to high- versus low-intensity coaching. Generalized estimating equations were used to assess interrelationships (odds ratios) between repeated measurements of health behaviors, depressive symptoms, and ≥5% reductions in baseline body weight and waist circumference. Results: Baseline coach empathy was associated with participant completion of 4-month session. Depression prevalence decreased from 21.7% to 9.5% over 12 months. Women consuming fruits/vegetables ≥5 times per day (versus <5) or any physical activity (vs. none) each had higher odds of improved depression screen, especially when women ≥55 years of age consumed more fruits/vegetables. Overweight/obese women who consumed fruits/vegetables ≥5 times/day (vs. <5) had higher odds of losing ≥5% body weight, while more physical activity (vs. <2.5 hours/week) had higher odds only among those with a positive depression screen. Furthermore, at-risk women with a negative depression screen (vs. positive) had higher odds of ≥5% decrease in waist circumference. Conclusion: Health behaviors/outcomes that are considered in a holistic, culturally relevant context could improve wellness and health equities. |
